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Peer-reviewedCC BY-NC-ND 4.0Annals of Gastroenterological Surgery

Comparison of Minimally Invasive Colectomy Between Intra‐ Versus Extra‐Corporeal Anastomosis Technique (COMMIT Study): Short‐Term Analysis

  • Takuya Takami1,2
  • Takehito Yamamoto1,2
  • Yoshiro Itatani1,2
  • Ryosuke Mizuno1,2
  • Kae Okoshi1,3
  • Yasunori Deguchi1,4
  • Keiji Nagata1,5
  • Tomoaki Okada1,6
  • Rei Mizuno1,7
  • Kazutaka Obama1,2
7 affiliations
  1. 1Kyoto Colorectal Surgery Study Group (KCRG) Kyoto Japan
  2. 2Department of Surgery, Graduate School of Medicine Kyoto University Kyoto Japan
  3. 3Department of Surgery Japan Baptist Hospital Kyoto Japan
  4. 4Department of Surgery Ijinkai Takeda General Hospital Kyoto Japan
  5. 5Department of Surgery Kokura Memorial Hospital Kitakyushu Japan
  6. 6Department of Gastrointestinal Surgery Japanese Red Cross Osaka Hospital Osaka Japan
  7. 7Department of Surgery National Hospital Organization Kyoto Medical Center Kyoto Japan
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Abstract

Aim: To compare the operative and short‐term outcomes between intracorporeal anastomosis (IA) and extracorporeal anastomosis (EA) in minimally invasive colectomy.

Methods: This multicenter cohort study used data from the Kyoto Colorectal Surgery Study Group database. Patients who underwent minimally invasive colectomy between 2018 and 2025 were included. Primary outcome was the incidence of intraoperative blood loss ≥ 200 mL. Secondary outcomes included continuous intraoperative blood loss, the incidence of intraoperative blood loss ≥ 100 and ≥ 300 mL, intraoperative blood transfusion, operative time, resection margins, harvested lymph node yield, and postoperative complications. Propensity score matching was performed to balance baseline characteristics.

Results: Of 3213 eligible patients, 928 and 2285 underwent IA and EA, respectively. After the propensity score matching, 650 matched pairs were identified. The incidence of intraoperative blood loss ≥ 200 mL was significantly lower in the IA group than that in the EA group (2.5% vs. 4.9%; risk difference, −2.46%; 95% confidence interval, −4.65% to −0.43%), whereas continuous intraoperative blood loss was comparable. Although operative time was generally longer for IA, subgroup analysis demonstrated significant effect modification according to surgical approach, with operative time tending to favor IA. The incidence of adequate resection margins tended to be higher in IA, although the difference was not statistically significant. Harvested lymph nodes and postoperative complications were generally comparable.

Conclusion: IA was associated with a lower incidence of intraoperative blood loss ≥ 200 mL during minimally invasive colectomy. These findings indicate that IA may reduce the occurrence of relatively high blood loss events.

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Cite

BibTeXRIS
BibTeX
@article{takami2026comparison,
  title = {{Comparison of Minimally Invasive Colectomy Between Intra‐ Versus Extra‐Corporeal Anastomosis Technique (COMMIT Study): Short‐Term Analysis}},
  author = {Takuya Takami and Takehito Yamamoto and Yoshiro Itatani and Ryosuke Mizuno and Kae Okoshi and Yasunori Deguchi and Keiji Nagata and Tomoaki Okada and Rei Mizuno and Kazutaka Obama},
  journal = {Annals of Gastroenterological Surgery},
  year = {2026},
  month = jul,
  doi = {10.1002/ags3.70252},
  url = {https://doi.org/10.1002/ags3.70252},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Comparison of Minimally Invasive Colectomy Between Intra‐ Versus Extra‐Corporeal Anastomosis Technique (COMMIT Study): Short‐Term Analysis
AU  - Takuya Takami
AU  - Takehito Yamamoto
AU  - Yoshiro Itatani
AU  - Ryosuke Mizuno
AU  - Kae Okoshi
AU  - Yasunori Deguchi
AU  - Keiji Nagata
AU  - Tomoaki Okada
AU  - Rei Mizuno
AU  - Kazutaka Obama
PY  - 2026
DA  - 2026/07/26
JO  - Annals of Gastroenterological Surgery
DO  - 10.1002/ags3.70252
UR  - https://doi.org/10.1002/ags3.70252
AB  - Aim: To compare the operative and short‐term outcomes between intracorporeal anastomosis (IA) and extracorporeal anastomosis (EA) in minimally invasive colectomy.  Methods: This multicenter cohort study used data from the Kyoto Colorectal Surgery Study Group database. Patients who underwent minimally invasive colectomy between 2018 and 2025 were included. Primary outcome was the incidence of intraoperative blood loss ≥ 200 mL. Secondary outcomes included continuous intraoperative blood loss, the incidence of intraoperative blood loss ≥ 100 and ≥ 300 mL, intraoperative blood transfusion, operative time, resection margins, harvested lymph node yield, and postoperative complications. Propensity score matching was performed to balance baseline characteristics.  Results: Of 3213 eligible patients, 928 and 2285 underwent IA and EA, respectively. After the propensity score matching, 650 matched pairs were identified. The incidence of intraoperative blood loss ≥ 200 mL was significantly lower in the IA group than that in the EA group (2.5% vs. 4.9%; risk difference, −2.46%; 95% confidence interval, −4.65% to −0.43%), whereas continuous intraoperative blood loss was comparable. Although operative time was generally longer for IA, subgroup analysis demonstrated significant effect modification according to surgical approach, with operative time tending to favor IA. The incidence of adequate resection margins tended to be higher in IA, although the difference was not statistically significant. Harvested lymph nodes and postoperative complications were generally comparable.  Conclusion: IA was associated with a lower incidence of intraoperative blood loss ≥ 200 mL during minimally invasive colectomy. These findings indicate that IA may reduce the occurrence of relatively high blood loss events.
SN  - 2475-0328
ER  -